Public Health Act 1984
The Public Health Act (Control of Disease) 1984 and the Public Health (Infectious Diseases) Regulations 1988 (as updated in 2010) are the main pieces of communicable disease legislation in England and Wales: see Notifiable diseases page for more information.
They provide a statutory basis for Surveillance of (notifiable) communicable diseases; and provide powers to, for example, remove people to hospital for examination or treatment, without their consent.
Parts II, V and VI of the Public Health (Control of Disease) Act 1984 have been undergoing a consultation process, and a report is now available covering the responses, and the policy which the government intends to take forward in the Health and Social Services Bill.
Removal to hospital for examination or treatment without consent
This section has been superseded by Health Protection (Part 2A orders) Regulations 2010.
Compulsory removal of an infected person to hospital - section 37
With a magistrates order under Section 37 of the Act a person may be removed to hospital if:
- They are suffering from a notifiable disease or one of a number of additional diseases;
- They are unable or unwilling to take proper precautions to preven the spread of infection;
AND as a result
- Serious risk of infection is caused to other people.
This section does not allow a person to be detained in hospital - for that to be done, an order under Section 38 of the Act is required.
Compulsory detention of an infected person in hospital - section 38
With a magistrates order under Section 38 of the Act a person may be detained in hospital. The order will permit them to:
- Detain a patient who is suffering from a notifiable disease or one of a number of additional diseases;
- For any reasonable period specified in the order;
BECAUSE otherwise, when he left the hospital
- He would not be provided with lodgings or accommodation where proper precautions to prevent the spread of the disease could be taken.
What is a reasonable period?
This is for the court to decide, but the magistrates will consider very seriously the recommendations of the Proper Officer requesting the order. The period will depend on the circumstances of the case. In one case - a person with TB who who was very chaotic, and inclined to move (so that DOTS could not be used), and stop treatment, I believe that the order stated that he was to be detained "until he had completed a course of antituberculous chemotherapy".
Problems with using the Public Health Act for compulsory detention
It is not entirely clear who should fund the hospital admission; still less how the compulsion should be applied, and who should pay for it.
It is inappropriate for doctors and nurses to detain a patient unless they are specifically trained to do so (as some psychiatric nurses are). The police won't do it. So sometimes a private security firm has to be employed, working shifts around the clock.
On occasions patients may be given incentives to remain in hospital. Since many of the patients in whom the Act is appropriate are vagrants who refuse to comply with e.g. TB treatment are not compliant, this sometimes means supplying them with alcohol and tobacco, which can be a problem in itself on a general medical ward.
Sections 31 and 32 of PHA 1984: Disinfection of premises; removal of person from infected house
Under Section 31 of the Act, the occupier of premises can be required to "cleanse and disinfect" the premises; and to "disinfect or, as the case may require, destroy any articles..."
If the occupier fails to comply, the local authority can take the necessary action, and charge the occupier for doing so.
Under Section 32 of the Act the local authority can "cause any person... to be removed to any temporary shelter or house accommodation provided by the authority", with or without their consent (using reasonable force) if necessary.
- Consent (lists various Acts under which individuals may be detained for reasons related to health or illness, or treated without their consent).
- Section 47 of the National Assistance Act 1948
- Mental Capacity Act 2005
- Serious Organised Crime And Police Act 2005 - provides general powers of arrest
- The Act does not seem to be available from an official source online, including the Office of Public Sector Information; but as part of a consultation about changing parts of the Act in 2007, much of the Act is available via the DH website.